Tuberculosis in HIV-Associated Cryptococcal Meningitis is Associated with an Increased Risk of Death

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dc.contributor.authorRutakingirwa, Morris K.
dc.contributor.authorCresswell, Fiona V.
dc.contributor.authorKwizera, Richard
dc.contributor.authorSsebambulidde, Kenneth
dc.contributor.authorKagimu, Enock
dc.contributor.authorNuwagira, Edwin
dc.contributor.authorTugume, Lillian
dc.contributor.authorMpoza, Edward
dc.contributor.authorDobbin, Joanna
dc.contributor.authorWilliams, Darlisha A.
dc.contributor.authorMuzoora, Conrad
dc.contributor.authorMeya, David B.
dc.contributor.authorBoulware, David R.
dc.contributor.authorHullsiek, Kathy H.
dc.contributor.authorRhein, Joshua
dc.date.accessioned2022-08-18T19:56:23Z
dc.date.available2022-08-18T19:56:23Z
dc.date.issued2020
dc.description.abstractuberculosis (TB) and cryptococcal meningitis are leading causes of morbidity and mortality in advanced HIV disease. Data are limited on TB co-infection among individuals with cryptococcal meningitis. We performed a retrospective analysis of HIV-infected participants with cryptococcal meningitis from 2010–2017. Baseline demographics were compared between three groups: ‘prevalent TB’ if TB treated >14 days prior to cryptococcal meningitis diagnosis, ‘concurrent TB’ if TB treated ± 14 days from diagnosis, or ‘No TB at baseline’. We used time-updated proportional-hazards regression models to assess TB diagnosis as a risk for death. Of 870 participants with cryptococcal meningitis, 50 (6%) had prevalent TB, 67 (8%) had concurrent TB, and 753 (86%) had no baseline TB. Among participants without baseline TB, 67 (9%) were diagnosed with incident TB (after >14 days), with a median time to TB incidence of 41 days (IQR, 22–69). The 18-week mortality was 50% (25/50) in prevalent TB, 46% (31/67) in concurrent TB, and 45% (341/753) in the no TB group (p = 0.81). However, TB co-infection was associated with an increased hazard of death (HR = 1.75; 95% CI, 1.33–2.32; p < 0.001) in a time-updated model. TB is commonly diagnosed in cryptococcal meningitis, and the increased mortality associated with co-infection is a public health concern.en_US
dc.identifier.citationRutakingirwa, M. K., Cresswell, F. V., Kwizera, R., Ssebambulidde, K., Kagimu, E., Nuwagira, E., ... & Rhein, J. (2020). Tuberculosis in HIV-associated cryptococcal meningitis is associated with an increased risk of death. Journal of Clinical Medicine, 9(3), 781.https://doi.org/10.3390/jcm9030781en_US
dc.identifier.urihttps://nru.uncst.go.ug/handle/123456789/4304
dc.language.isoenen_US
dc.publisherJournal of Clinical Medicineen_US
dc.subjectTuberculosis; cryptococcal meningitis; HIV; Cryptococcus; AIDS-related opportunistic infections; co-infectionen_US
dc.titleTuberculosis in HIV-Associated Cryptococcal Meningitis is Associated with an Increased Risk of Deathen_US
dc.typeArticleen_US
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